Safety comparison of minimally invasive abdomen-only esophagectomy versus minimally invasive Ivor Lewis esophagectomy: a retrospective cohort study

被引:1
作者
Wang, Christopher P. [1 ]
Rogers, Michael P. [2 ]
Bach, Gregory [2 ]
Sujka, Joseph [2 ]
Mhaskar, Rahul [3 ]
DuCoin, Christopher [2 ]
机构
[1] Univ S Florida, Morsani Coll Med, Tampa, FL 33620 USA
[2] Univ S Florida, Morsani Coll Med, Div Gastrointestinal Surg, Dept Surg, 5 Tampa Gen Circle, Tampa, FL 33606 USA
[3] Univ S Florida, Morsani Coll Med, Dept Internal Med, Tampa, FL 33620 USA
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2022年 / 36卷 / 03期
关键词
Safety comparison; Minimally invasive esophagectomy; Ivor Lewis; Abdomen-only esophagectomy; Adenocarcinoma; Stricture;
D O I
10.1007/s00464-021-08468-0
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background We report mortality and post-operative complications from esophageal resection in the treatment of gastroesophageal adenocarcinoma or stricture, comparing a minimally invasive abdomen-only esophagectomy (MIAE) approach with a minimally invasive Ivor Lewis esophagectomy (MIILE) approach. Methods A single-center retrospective cohort study of patients with esophageal adenocarcinoma or stricture treated by either MIAE or MIILE was conducted. MIAE was offered for strictures less than five centimeters or cancers that were American Joint Committee on Cancer (AJCC) Stage <= T2 without lymphadenopathy. Patients treated with these surgical techniques were analyzed to assess pre-operative risk, intra and post-operative variables, adverse events, and overall survival. Results This study included 17 patients undergoing MIAE and 32 patients treated with MIILE. There were a fewer median number of lymph nodes resected (p < 0.001) and shorter operative duration (p < 0.001) for MIAE compared to MIILE. MIAE patients also had significantly higher Charlson Comorbidity Index scores and ACS National Surgical Quality Improvement Program (NSQIP) surgical risk values than MIILE patients (p < 0.05). There was no difference in median estimated blood loss, length of stay, pulmonary or cardiac complications between groups. There was no significant difference in 90-day survival. Conclusion A minimally invasive abdomen-only approach in a specific patient population is comparable in safety to a minimally invasive Ivor Lewis approach, with associated shorter median operative duration. MIAE patients had significantly greater pre-operative comorbidities and higher calculated peri-operative risk of complication but demonstrated similar post-operative outcomes. This suggests that MIAE may be a suitable surgical approach for treating gastroesophageal adenocarcinoma or stricture in patients deemed unsuitable for MIILE.
引用
收藏
页码:1887 / 1893
页数:7
相关论文
共 21 条
  • [1] Guidelines for the management of oesophageal and gastric cancer
    Allum, William H.
    Blazeby, Jane M.
    Griffin, S. Michael
    Cunningham, David
    Jankowski, Janusz A.
    Wong, Rachel
    [J]. GUT, 2011, 60 (11) : 1449 - 1472
  • [2] Transhiatal versus transthoracic esophagectomy for esophageal cancer
    Barreto, J. Camilo
    Posner, Mitchell C.
    [J]. WORLD JOURNAL OF GASTROENTEROLOGY, 2010, 16 (30) : 3804 - 3810
  • [3] A comparative study of survival after minimally invasive and open oesophagectomy
    Burdall, Oliver C.
    Boddy, Alexander P.
    Fullick, James
    Blazeby, Jane
    Krysztopik, Richard
    Streets, Christopher
    Hollowood, Andrew
    Barham, Christopher P.
    Titcomb, Dan
    [J]. SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2015, 29 (02): : 431 - 437
  • [4] The Role of Lymphadenectomy in Esophageal Cancer
    Darling, Gail
    [J]. JOURNAL OF SURGICAL ONCOLOGY, 2009, 99 (04) : 189 - 193
  • [5] Gibbs JF, 2007, J NATL MED ASSOC, V99, P620
  • [6] Distribution of lymph node metastases in esophageal carcinoma [TIGER study]: study protocol of a multinational observational study
    Hagens, Eliza R. C.
    Henegouwen, Mark I. van Berge
    van Sandick, Johanna W.
    Cuesta, Miguel A.
    van der Peet, Donald L.
    Heisterkamp, Joos
    Nieuwenhuijzen, Grard A. P.
    Rosman, Camiel
    Scheepers, Joris J. G.
    Sosef, Meindert N.
    van Hillegersberg, Richard
    Lagarde, Sjoerd M.
    Nilsson, Magnus
    Rasanen, Jari
    Nafteux, Philippe
    Pattyn, Piet
    Hoelscher, Arnulf H.
    Schroeder, Wolfgang
    Schneider, Paul M.
    Mariette, Christophe
    Castoro, Carlo
    Bonavina, Luigi
    Rosati, Riccardo
    de Manzoni, Giovanni
    Mattioli, Sandro
    Roig Garcia, Josep
    Pera, Manuel
    Griffin, Michael
    Wilkerson, Paul
    Chaudry, M. Asif
    Sgromo, Bruno
    Tucker, Olga
    Cheong, Edward
    Moorthy, Krishna
    Walsh, Thomas N.
    Reynolds, John
    Tachimori, Yuji
    Inoue, Haruhiro
    Matsubara, Hisahiro
    Kosugi, Shin-ichi
    Chen, Haiquan
    Law, Simon Y. K.
    Pramesh, C. S.
    Puntambekar, Shailesh P.
    Murthy, Sudish
    Linden, Philip
    Hofstetter, Wayne L.
    Kuppusamy, Madhan K.
    Shen, K. Robert
    Darling, Gail E.
    [J]. BMC CANCER, 2019, 19 (1)
  • [7] The extent of lymphadenectomy in esophageal resection for cancer should be standardized
    Hagens, Eliza R. C.
    Henegouwen, Mark I. van Berge
    Cuesta, Miguel A.
    Gisbertz, Suzanne S.
    [J]. JOURNAL OF THORACIC DISEASE, 2017, 9 : S713 - S723
  • [8] Chemotherapy followed by surgery compared with surgery alone for localized esophageal cancer
    Kelsen, DP
    Ginsberg, R
    Pajak, TF
    Sheahan, DG
    Gunderson, L
    Mortimer, J
    Estes, N
    Haller, DG
    Ajani, J
    Kocha, W
    Minsky, BD
    Roth, JA
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (27) : 1979 - 1984
  • [9] What Should Be the Gold Standard for the Surgical Component in the Treatment of Locally Advanced Esophageal Cancer Transthoracic Versus Transhiatal Esophagectomy
    Kutup, Asad
    Nentwich, Michael F.
    Bollschweiler, Elfriede
    Bogoevski, Dean
    Izbicki, Jakob R.
    Hoelscher, Arnulf H.
    [J]. ANNALS OF SURGERY, 2014, 260 (06) : 1016 - 1022
  • [10] Thoracoscopic-laparoscopic esophagectomy and two-field lymph node dissection
    Li, Kun-Kun
    Wang, Yin-Jian
    Liu, Xue-Hai
    Guo, Wei
    [J]. JOURNAL OF THORACIC DISEASE, 2019, 11 (06) : 2571 - 2575